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Cervical neural space narrowing during simulated rear crashes with anti-whiplash systems

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Abstract

Purpose

Chronic radicular symptoms have been documented in whiplash patients, potentially caused by cervical neural tissue compression during an automobile rear crash. Our goals were to determine neural space narrowing of the lower cervical spine during simulated rear crashes with whiplash protection system (WHIPS) and active head restraint (AHR) and to compare these data to those obtained with no head restraint (NHR). We extrapolated our results to determine the potential for cord, ganglion, and nerve root compression.

Methods

Our model, consisting of a human neck specimen within a BioRID II crash dummy, was subjected to simulated rear crashes in a WHIPS seat (n = 6, peak 12.0 g and ΔV 11.4 kph) or AHR seat and subsequently with NHR (n = 6, peak 11.0 g and ΔV 10.2 kph with AHR; peak 11.5 g and ΔV 10.7 kph with NHR). Cervical canal and foraminal narrowing were computed and average peak values statistically compared (P < 0.05) between WHIPS, AHR, and NHR.

Results

Average peak canal and foramen narrowing could not be statistically differentiated between WHIPS, AHR, or NHR. Peak narrowing with WHIPS or AHR was 2.7 mm for canal diameter and 1.6 mm, 2.7 mm, and 5.9 mm2 for foraminal width, height and area, respectively.

Conclusions

While lower cervical spine cord compression during a rear crash is unlikely in those with normal canal diameters, our results demonstrated foraminal kinematics sufficient to compress spinal ganglia and nerve roots. Future anti-whiplash systems designed to reduce cervical neural space narrowing may lead to reduced radicular symptoms in whiplash patients.

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References

  1. Barnsley L, Lord S, Bogduk N (1994) Whiplash injury. Pain 58:283–307

    Article  PubMed  CAS  Google Scholar 

  2. Chien A, Eliav E, Sterling M (2008) Whiplash (grade II) and cervical radiculopathy share a similar sensory presentation: an investigation using quantitative sensory testing. Clin J Pain 24:595–603

    Article  PubMed  Google Scholar 

  3. Humphreys SC, Hodges SD, Patwardhan A, Eck JC, Covington LA, Sartori M (1998) The natural history of the cervical foramen in symptomatic and asymptomatic individuals aged 20–60 years as measured by magnetic resonance imaging. A descriptive approach. Spine (Phila Pa 1976) 23:2180–2184

    Article  CAS  Google Scholar 

  4. Hardy AG (1977) Cervical spinal cord injury without bony injury. Paraplegia 14:296–305

    Article  PubMed  CAS  Google Scholar 

  5. Chen IH, Vasavada A, Panjabi MM (1994) Kinematics of the cervical spine canal: changes with sagittal plane loads. J Spinal Disord 7:93–101

    Article  PubMed  CAS  Google Scholar 

  6. Holmes A, Han ZH, Dang GT, Chen ZQ, Wang ZG, Fang J (1996) Changes in cervical canal spinal volume during in vitro flexion–extension. Spine (Phila Pa 1976) 21:1313–1319

    Article  CAS  Google Scholar 

  7. Ebraheim NA, Liu J, Shafiq Q, Lu J, Pataparla S, Yeasting RA, Woldenberg L (2006) Quantitative analysis of changes in cervical intervertebral foramen size with vertebral translation. Spine (Phila Pa 1976) 31:E62–E65

    Article  Google Scholar 

  8. Nuckley DJ, Konodi MA, Raynak GC, Ching RP, Mirza SK (2002) Neural space integrity of the lower cervical spine: effect of normal range of motion. Spine 27:587–595

    Article  PubMed  Google Scholar 

  9. Ivancic PC, Xiao M (2011) Understanding whiplash injury and prevention mechanisms using a human model of the neck. Accid Anal Prev 43:1392–1399

    Article  PubMed  Google Scholar 

  10. Ivancic PC, Sha D, Panjabi MM (2009) Whiplash injury prevention with active head restraint. Clin Biomech (Bristol, Avon) 24:699–707

    Article  Google Scholar 

  11. Ivancic PC, Panjabi MM, Ito S (2006) Cervical spine loads and intervertebral motions during whiplash. Traffic Inj Prev 7:389–399

    Article  PubMed  Google Scholar 

  12. Ortengren T, Hansson HA, Lovsund P, Svensson MY, Suneson A, Saljo A (1996) Membrane leakage in spinal ganglion nerve cells induced by experimental whiplash extension motion: a study in pigs. J Neurotrauma 13:171–180

    Article  PubMed  CAS  Google Scholar 

  13. Nuckley DJ, Van Nausdle JA, Raynak GC, Eck MP, Harrington RM, Ching RP (2003) Examining the relationship between whiplash kinematics and a direct neurologic injury mechanism. Int J Vehicle Des 31:68–82

    Article  Google Scholar 

  14. Ito S, Panjabi MM, Ivancic PC, Pearson AM (2004) Spinal canal narrowing during simulated whiplash. Spine 29:1330–1339

    Article  PubMed  Google Scholar 

  15. Panjabi MM, Maak TG, Ivancic PC, Ito S (2006) Dynamic intervertebral foramen narrowing during simulated rear impact. Spine 31:E128–E134

    Article  PubMed  Google Scholar 

  16. Ivancic PC, Panjabi MM, Ito S, Cripton PA, Wang JL (2005) Biofidelic whole cervical spine model with muscle force replication for whiplash simulation. Eur Spine J 14:346–355

    Article  PubMed  CAS  Google Scholar 

  17. Descarreaux M, Blouin JS, Teasdale N (2003) A non-invasive technique for measurement of cervical vertebral angle: report of a preliminary study. Eur Spine J 12:314–319

    PubMed  Google Scholar 

  18. Panjabi MM, Duranceau J, Goel V, Oxland T, Takata K (1991) Cervical human vertebrae. Quantitative three-dimensional anatomy of the middle and lower regions. Spine 16:861–869

    Article  PubMed  CAS  Google Scholar 

  19. Panjabi MM, Oxland TR, Parks EH (1991) Quantitative anatomy of cervical spine ligaments. Part II. Middle and lower cervical spine. J Spinal Disord 4:277–285

    Article  PubMed  CAS  Google Scholar 

  20. Ebraheim NA, An HS, Xu R, Ahmad M, Yeasting RA (1996) The quantitative anatomy of the cervical nerve root groove and the intervertebral foramen. Spine 21:1619–1623

    Article  PubMed  CAS  Google Scholar 

  21. Pearson AM, Ivancic PC, Ito S, Panjabi MM (2004) Facet joint kinematics and injury mechanisms during simulated whiplash. Spine 29:390–397

    Article  PubMed  Google Scholar 

  22. Farmer CM, Wells JK, Lund AK (2003) Effects of head restraint and seat redesign on neck injury risk in rear-end crashes. Traffic Inj Prev 4:83–90

    Article  PubMed  Google Scholar 

  23. Kaneoka K, Ono K, Inami S, Yokoi N, Hayashi K (1997) Human cervical spine kinematics during whiplash loading. In: International conference on new frontiers in biomechanical engineering. Tokyo, Japan, pp. 265–268

  24. Viano DC (2002) Role of seat in car crash safety. Society of Automotive Engineers, Inc., Warrendale, PA, USA

  25. NHTSA (2012) National Highway Traffic Safety Administration. National Automotive Sampling System–Crashworthiness Data System. US Department of Transportation, Washington. http://www.nhtsa.gov/NASS.; ftp://ftp.nhtsa.dot.gov/NASS/. Accessed Jan 2012

  26. Xiao M, Ivancic PC (2010) WHIPS seat and occupant motions during simulated rear crashes. Traffic Inj Prev 11:514–521

    Article  PubMed  Google Scholar 

  27. Kent R, Henary B, Matsuoka F (2005) On the fatal crash experience of older drivers. Annu Proc Assoc Adv Automot Med 49:371–391

    PubMed  Google Scholar 

  28. Morris A, Welsh R, Hassan A (2003) Requirements for the crash protection of older vehicle passengers. Annu Proc Assoc Adv Automot Med 47:165–180

    PubMed  Google Scholar 

  29. Tominaga Y, Maak TG, Ivancic PC, Panjabi MM, Cunningham BW (2006) Head-turned rear impact causing dynamic cervical intervertebral foramen narrowing: implications for ganglion and nerve root injury. J Neurosurg Spine 4:380–387

    Article  PubMed  Google Scholar 

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Acknowledgments

This research was supported by Grant 5R01CE001257 from the Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA. We thank Daohang Sha, PhD, and Ming Xiao, PhD, for their contributions to this study.

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Authors and Affiliations

  1. Biomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, 333 Cedar St, P.O. Box 208071, New Haven, CT, 06520-8071, USA

    Paul C. Ivancic

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Correspondence to Paul C. Ivancic.

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Ivancic, P.C. Cervical neural space narrowing during simulated rear crashes with anti-whiplash systems. Eur Spine J 21, 879–886 (2012). https://doi.org/10.1007/s00586-012-2159-5

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  • DOI: https://doi.org/10.1007/s00586-012-2159-5

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